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Abstract
During the prenatal period, maternal and fetal cells compete for calories and nutrients.
To ensure the survival of the mother and development of the fetus, the prenatal hormonal milieu
alters the competitive environment via metabolic perturbations (e.g., insulin resistance). These
perturbations increase maternal caloric consumption and engender increments in both maternal fat
mass and the number of calories captured by the fetus. However, a mother’s metabolic and behavioral
phenotypes (e.g., physical activity levels) and her external environment (e.g., food availability) can
asymmetrically impact the competitive milieu, leading to irreversible changes in pre- and post- natal development—as exhibited by stunting and obesity. Therefore, the interaction of maternal
metabolism, behavior, and environment impact the competition for calories—which in turn creates a
continuum of health trajectories in offspring. In sum, the inheritance of metabolic phenotypes offers
a comprehensive and consilient explanation for much of the increase in obesity and T2DM over the
past 50 years in human and non-human mammals.